The clinical need for chest drainage arises anytime the negative pressure in the pleural cavity is disrupted by the presence of air and/or fluid resulting in pulmonary compromise. The purpose of a chest drainage device is to evacuate the air and/or fluid from the chest cavity to help re-establish normal intrathoracic pressure. This facilitates the re-expansion of the lungs to restore normal briefing dynamics. The need also arises following heart surgery to prevent the accumulation of fluid around the heart.
FIG. 1 shows a conventional medical drainage device 1, which is used for a chest drainage. The medical drainage device 1 includes a casing 11 and attached to the casing includes a patient drain catheter 12. This in turn is connected to either a thoracic or trocar catheter. Patients with continual air or fluid leaks have such a thoracic catheter, also called chest tube, inserted. The distal end of the catheter, which will be inside the patient's chest, has a number of drainage holes. The last inlet can be detected on a chest X-ray as intermittent breaks in a radiopaque line. Once the chest tube has been properly positioned and secured, the X-ray should be checked to ensure that all drainage holes are inside the chest wall.
The location of the chest tube depends on what is being drained. Free air in the pleural space rises, so the tube is placed above the second intercostal space at the mid-clavicular line. Plural fluid gravitates to the most dependent point, so the tube is placed at the fourth to fifth intercostal space along the mid-axillary line. Mediastinal tubes placed to drain the pericardium after open-heart surgery are positioned directly under the sternum. Once the chest tube is in place, it is connected to a medical drainage device 1, usually called chest drainage unit (CDU) via the patient drain catheter 12.
The patient drain catheter 12 is directly connected to a collection chamber 14 of the medical drainage device 1 and any drainage from the chest flows into this collection chamber 14. The collection chamber 14 is graduated to provide an assessment and has a write-on surface to allow for recording of the time, date and amount of drainage.
The medical drainage device 1 further includes a chamber 15 which in traditional medical drainage devices is the water seal area. The main purpose of the water seal is to allow air to exit from the pleural space on exhalation and prevent air from entering the plural cavity or mediastinum on inhalation.
The medical drainage device 1 further includes a suction control regulator. The amount of suction, i.e. of negative pressure, applied to the patient's body is indicated by the height 18 of water 17 on a graduated scale. This is called the Patient Assessment manometer. A suction pressure of between 15-20 cm H2O is commonly recommended. Lower levels may be indicated for infants and for patients with friable lung tissue or if ordered by the physician. These medical drainage devices are normally stationary either by placing them on the floor or hanging them on the bed rail below the chest.
When a medical drainage device 1 is being prepared for the use, sterile water is filled into both the water seal chamber 15 and the patient assessment manometer chamber 16 until it reaches the fill lines. The patient assessment manometer provides an assessment of negative pressure within the collection chamber and patient chest. This is accomplished by a true U tube water manometer design in the medical drainage device which indicates patient intrapleural pressure. At the bottom of this manometer chamber 16 there is a dyeing device 13, usually a die ball, which dies the water, e.g. blue, which makes it easier for the nurse and/or the physician to see the suction level applied to the patient i.e. the water height 18. The dyeing device 13 floats around freely at the bottom of this chamber 16.
During the preparation and setup of the medical drainage device 1 an instruction tape is removed from the opening 19. It is into this opening 19 that the sterile water is poured to fill the patient assessment manometer to the required level.
The problems that arise with such a medical drainage device are that there is a risk that the dyeing device 13 falls out of the patient assessment manometer chamber 16 through the opening 19. Additionally, when the water is filled through the opening 19 into this chamber 16, it is quite difficult since the opening 19 usually is very small and therefore a lot of water will fall outside the hole 19.
It is therefore an object of the present disclosure to reduce the disadvantages of the prior art.